title: Mycobacterium tuberculosis cluster with developing drug resistance, New York, New York, USA, 2003-2009.
abstract: In 2004, identification of patients infected with the same Mycobacterium tuberculosis strain in New York, New York, USA, resulted in an outbreak investigation. The investigation involved data collection and analysis, establishing links between patients, and forming transmission hypotheses. Fifty-four geographically clustered cases were identified during 2003-2009. Initially, the M. tuberculosis strain was drug susceptible. However, in 2006, isoniazid resistance emerged, resulting in isoniazid-resistant M. tuberculosis among 17 (31%) patients. Compared with patients with drug-susceptible M. tuberculosis, a greater proportion of patients with isoniazid-resistant M. tuberculosis were US born and had a history of illegal drug use. No patients named one another as contacts. We used patient photographs to identify links between patients. Three links were associated with drug use among patients infected with isoniazid-resistant M. tuberculosis. The photographic method would have been more successful if used earlier in the investigation. Name-based contact investigation might not identify all contacts, particularly when illegal drug use is involved.
authors.forename: Bianca R
authors.initials: BR
authors.lastname: Perri
authors.forename: Douglas
authors.initials: D
authors.lastname: Proops
authors.forename: Patrick K
authors.initials: PK
authors.lastname: Moonan
authors.forename: Sonal S
authors.initials: SS
authors.lastname: Munsiff
authors.forename: Barry N
authors.initials: BN
authors.lastname: Kreiswirth
authors.forename: Natalia
authors.initials: N
authors.lastname: Kurepina
authors.forename: Christopher
authors.initials: C
authors.lastname: Goranson
authors.forename: Shama D
authors.initials: SD
authors.lastname: Ahuja
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000494:pharmacology*; D002648:Child; D016000:Cluster Analysis; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial; D055030:Drug Users; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000494:pharmacology*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000187:drug effects* / Q000235:genetics; D009519:New York City / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid